K Number
K171111
Device Name
Sculpsure
Manufacturer
Date Cleared
2017-06-13

(60 days)

Product Code
Regulation Number
878.5400
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Cynosure SculpSure™ is intended for non-invasive lipolysis of the abdomen, flanks, back, and thighs in individuals with a Body Mass Index (BMI) of 30 or less. The device is intended to affect the appearance of visible fat bulges in the abdomen, flanks, back, and thighs.

Device Description

The Cynosure SculpSure is a diode laser system. The main components of SculpSure are a console and four applicators that deliver the laser energy to the patient. Electrically efficient semiconductors generate optical radiation (1060 nm) which is used to deliver laser energy to subcutaneous tissue layers.

AI/ML Overview

Acceptance Criteria and Study Details for SculpSure Device

The SculpSure device is intended for non-invasive lipolysis to reduce fat in specific body areas. The following information details the acceptance criteria and the study that demonstrated the device meets these criteria.

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
Effectiveness - Photographic AssessmentBlind evaluators able to identify 86% of post-treatment photographs (Back: 91%, Outer Thigh: 87%, Inner Thigh: 83%).
Effectiveness - Fat Reduction (Ultrasound)At 12-week post-follow-up, average 8.6% normalized fat reduction (Back: 10.6%, Outer Thigh: 7.2%, Inner Thigh: 8.0%). All treatments had a p-value of <0.01, indicating statistical significance.
Patient Satisfaction83% satisfaction rate at 12-week post-follow-up visit (Back: 81%, Outer Thigh: 88%, Inner Thigh: 80%).
Safety - Adverse EventsAll 168 subjects were included in the safety analysis. All adverse events were transient and majority mild in nature. No serious adverse events were reported.

(Note: The document does not explicitly state pre-defined acceptance criteria values (e.g., "must achieve >X% fat reduction"). Instead, it reports the observed performance and concludes that the results demonstrate safety and effectiveness for substantial equivalence. The reported performance values in the table are the actual results from the study.)

2. Sample Size and Data Provenance for Test Set

  • Sample Size: A total of 168 subjects, making up 214 treatment areas, were enrolled in the study.
    • Back: 55 subjects / 55 treatment areas
    • Outer Thigh: 52 subjects / 52 treatment areas
    • Inner Thigh: 61 subjects / 107 treatment areas
  • Data Provenance: The study was a prospective, controlled study conducted at 3 study centers. The specific country of origin is not explicitly stated, but it can be inferred to be within the US given the submission to the FDA.

3. Number of Experts and Qualifications for Ground Truth

The document mentions "blind evaluation of pre and post treatment (12-week) photographs," and "blind evaluators were able to identify 86% of the post treatment photographs." However, the number of experts used to establish the ground truth for the test set and their specific qualifications are not provided in the provided text.

4. Adjudication Method

The document states "blind evaluation of pre and post treatment (12-week) photographs." This indicates a degree of blinding. However, the specific adjudication method (e.g., 2+1, 3+1, none) is not explicitly stated for establishing ground truth or for resolving discrepancies in photographic evaluation.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No MRMC comparative effectiveness study was done comparing human readers with and without AI assistance. The study evaluated the device's efficacy in non-invasive fat reduction.

6. Standalone (Algorithm Only) Performance

This device is a laser system (SculpSure), not an AI algorithm. Therefore, the concept of "standalone (i.e., algorithm only without human-in-the-loop performance)" does not apply to this medical device. The study evaluates the performance of the physical device as used by a human operator.

7. Type of Ground Truth Used

The efficacy of the treatment was assessed using a combination of:

  • Photographic assessment: Blind evaluation of pre and post-treatment photographs.
  • Ultrasound imaging: Measurement of percentage change in adipose tissue thickness from baseline to 12-week follow-up.

8. Sample Size for the Training Set

The document describes a clinical study to evaluate the device's safety and efficacy for specific body areas. This study serves as the primary evidence for the device's performance. The concept of a "training set" typically applies to machine learning models. For a physical device like SculpSure, the provided documentation does not refer to a separate "training set" in the context of clinical studies.

9. How the Ground Truth for the Training Set was Established

As mentioned above, the concept of a "training set" as it applies to software or AI algorithms is not directly relevant here. The "ground truth" for the clinical study's effectiveness was established through the objective measurements of ultrasound imaging for fat reduction and the subjective yet blinded assessment of photographic changes.

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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

June 13, 2017

Cynosure, Inc Ms. Amy Tannenbaum Regulatory Affairs Specialist 5 Carlisle Road Westford, Massachusetts 01886

Re: K171111

Trade/Device Name: Sculpsure Regulation Number: 21 CFR 878.5400 Regulation Name: Low level laser system for aesthetic use Regulatory Class: Class II Product Code: PKT Dated: April 13, 2017 Received: April 14, 2017

Dear Ms. Tannenbaum:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Actinclude requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device

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related adverse events) (21 CFR 803): good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely,

Jennifer R. Stevenson -S3

For Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K171111

Device Name SculpSure™

Indications for Use (Describe)

The Cynosure SculpSure™ is intended for non-invasive lipolysis of the abdomen, flanks, back, and thighs in individuals with a Body Mass Index (BMI) of 30 or less. The device is intended to affect the appearance of visible fat bulges in the abdomen, flanks, back, and thighs.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)

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Section 5

510(k) Summary

510(k) Summary for SculpSure Laser System

A summary of 510(k) safety and effectiveness information in accordance with the requirements of 21 CFR 807.92.

807.92(a)(1) Submitter Information
ApplicantCynosure, Inc.
Address5 Carlisle RoadWestford, MA 01886
Phone Number(781)-993-2454
Fax Number(978) 256-6556
Establishment RegistrationNumber1222993
Contact PersonAmy Tannenbaum
Preparation DateApril 13, 2017
807.92(a)(2) Name of Device
Trade or Proprietary NameSculpSure
Common or Usual NameLaser
Classification NameLaser for disruption of adipocyte cells for aesthetic use
Classification PanelGeneral & Plastic Surgery
Regulation21 CFR 878.5400
Regulatory ClassII
Product Code(s)PKT
807.92 (a)(3) Legally marketed device(s) to which equivalence is claimed
Predicate DevicesCynosure SculpSure K160470Zeltiq Coolsculpting K162050The predicate devices have not been subject to a design-relatedrecall.
807.92(a)(4) Device Description
The Cynosure SculpSure is a diode laser system. The maincomponents of SculpSure are a console and four applicators thatdeliver the laser energy to the patient. Electrically efficientsemiconductors generate optical radiation (1060 nm) which isused to deliver laser energy to subcutaneous tissue layers.
807.92(a)(5) Intended Use of the Device
The SculpSure laser system is intended for non-invasive lipolysisof the abdomen, flanks, back, and thighs, in individuals with a

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Section 5

510(k) Summary

807.92(a)(6) Summary of the Technological Characteristics of the Device Compared to the Predicate
Proposed SculpSure Laser SystemCynosure SculpSure Laser SystemZeltiq Coolsculpting Device
510(k) NumberPendingK160470K162050
ManufacturerCynosure, Inc.Cynosure, Inc.Zeltiq Aesthetics, Inc.
Lipolysis MethodHeat-assistedHeat-assistedCold-assisted
Device TypeDiode LaserDiode LaserN/A
Wavelength1060 ±20 nm(infrared)1060 ±20 nm(infrared)N/A
Spot Size4 x 6 cm² on each ofthe Applicator heads4 x 6 cm² on each ofthe Applicator heads4.5 x 7 cm² (2x)approximate
Pulse Width (laser ON time)CWCWN/A
Power DensityUp to 1.4 W/cm²Up to 1.4 W/cm²N/A
Attachment to patientBeltBeltBelt
Voltage200-240V~, Single Phase200-240V~, Single PhaseN/A
Current20A20AN/A

807.92(b)(1) Non-clinical tests submitted

There have been minor changes to the software from the previously cleared SculpSure in K160470. These changes have been addressed and additional information is available in Section 16. There have been no changes to the biocompatibility or electrical safety testing from the previously cleared SculpSure device. Additional information is available in Section 15 and Section 17, respectively.

807.92(b)(2) Clinical tests submitted

Prospective, controlled studies were conducted at 3 study centers to evaluate the safety and efficacy of Cynosure SculpSure laser for the non-invasive fat reduction of the inner thigh, outer thigh and back. The study was conducted in the same manner as the previous abdomen and flanks studies. The treatment techniques used and subsequent follow up schedule for the study were kept consistent between the studies. A total of 168 subjects, making up 214 treatment areas, were enrolled in the study. This is broken down into 55 subjects/55 treatment areas for back, 52 subjects/52 treatment areas for outer thigh, and 61 subjects/107 treatment areas for inner thighs

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Each subject received 1 treatment with the SculpSure. Treatment effectiveness was assessed through blind evaluation of pre and post treatment (12-week) photographs; percentage change in the adipose tissue thickness from baseline to the12-week follow up measured through ultrasound imaging; and patient satisfaction measured at the 12-week post treatment follow up visit through a 6-point Likert scale. All subjects that were treated in the study were included in the safety analysis and adverse events were assessed at all visits. On an average, blind evaluators were able to identify 86% of the post treatment photographs (back 91%, outer thigh 87% and inner thigh 83%); ultrasound imaging at 12-week post follow up visit showed 8.6% normalized fat reduction (back 10.6%, outer thigh 7.2%, and inner thigh 8.0%). All treatments had a p-value of <0.01 indicating that results were statistically significant. The patient satisfaction survey at 12 week post follow up visit showed 83% satisfaction rate (back 81%, outer thigh 88% and inner thigh 80%). All168 subjects were included in the safety analysis and adverse events reporting. All events were transient and majority was mild in nature. There were no serious adverse events. The study concluded that the SculpSure is safe and effective for non-invasive fat reduction for the back and thighs.

807.92(b)(3) Conclusions drawn from clinical and non-clinical tests submitted

Cynosure believes that SculpSure is substantially equivalent to its predicate devices with same intended use and similar technological characteristics. The non-clinical data for SculpSure supports the safety of the device and the biocompatibility, hardware and software verification and validation demonstrate that the SculpSure should perform as intended in the specified use conditions. Additionally, the successful clinical performance of SculpSure as documented in the clinical study demonstrate that the SculpSure has a safety and effectiveness profile that is similar to its predicate devices with a successful treatment of the back and thighs.

§ 878.5400 Low level laser system for aesthetic use

(a)
Identification. A Low Level Laser System for Aesthetic Use is a device using low level laser energy for the disruption of adipocyte cells within the fat layer for the release of fat and lipids from these cells for noninvasive aesthetic use.(b)
Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Low Level Laser System for Aesthetic Use.” See § 878.1(e) for the availability of this guidance document.